For women who are actively trying for a baby – or for those who are already pregnant – it is important to know that there are things that can affect their chances of having a safe pregnancy.

This week the therapeutic goods administration (TGA) published a safety review of anti-inflammatory pain killers for women who are pregnant or trying for a baby. The TGA advice warns that there are certain medications known as NSAIDS (non-steroidal anti-inflammatory drugs) that can increase a pregnant woman’s chance of having a miscarriage, particularly when taken close to the time of conception. The TGA review findings also applied to aspirin despite being a different type of medication.

What are NSAIDS?

NSAIDS are medications that are widely used to treat pain, inflammation and fever. They can also be used to treat the symptoms of arthritis, muscle or tendon strains, and period pain. In Australia, NSAID drugs include:

celecoxib

diclofenac

etoricoxib

flurbiprofen

ibuprofen

indometacin (previously known as indomethacin)

ketoprofen

ketorolac trometamol

mefenamic acid

meloxicam

naproxen

parecoxib

piroxicam

sulindac

However, many of the medications may be better known to patients by more familiar “brand” names (e.g. Neurofen (ibuprofen) and Voltaren (diclofenac)).

What about period pain?

There is no evidence that using NSAIDs for pain relief during the first few days of a menstrual period increases the risk of miscarriage in that month.

Some treatment guidelines for the management of period pain recommend starting NSAIDS the day before a period is expected. This recommendation should not be followed by women who are a) trying to conceive or b) may be pregnant.

What is safe for me to take?

If you are pregnant, or are trying to become pregnant, consult a health professional before using NSAIDs and consider using an alternative medicine. In most cases, paracetamol (Panadol) is considered a safe pain medication.

Article by Dr Raelia Lew. Raelia is working with Your Fertility in 2016 as part of her certification in reproductive endocrinology and infertility from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZOG).